Healthcare Provider Details

I. General information

NPI: 1609326875
Provider Name (Legal Business Name): SURGONE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2016
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E 19TH AVE SUITE 6300
DENVER CO
80218-1216
US

IV. Provider business mailing address

8490 E CRESCENT PKWY STE 380
GREENWOOD VILLAGE CO
80111-2815
US

V. Phone/Fax

Practice location:
  • Phone: 303-839-5669
  • Fax: 303-839-1216
Mailing address:
  • Phone: 303-957-1310
  • Fax: 303-761-4252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SHELBY UHERNIK
Title or Position: CEO
Credential: MBA
Phone: 303-957-1310